Application Form: 2022 Korean Homeland Education (K-HED)
※ How to fill out: □ Indicate your choice with a check ( ) mark.∨
This application form may be photocopied and used in multiple copies.
※
If above mentioned information is not accurate, it may be sufficient cause for terminating your enrollment.
※
When applying for Online education, please leave the diplomatic office’s recommendation field empty.
※ Name
Korean Date of Birth yyyy / mm / dd
Photo 3.5 × 4.5 ㎝ English
(as shown in your passport)
Sex □ Male □ Female
Telephone Number (Include Country Code)
Country of Birth Mobile phone Number
Nationality Passport Number
Application for National
Scholarship □ Apply □ Do not apply Address
E-mail Korean Language
Fluency
□ Advanced
□ Intermediate
□ Beginner
Type of Course
Invitation
University Preparation Course
□
(Admission Focus Class)
□ Spring (blending): 4. 1 ~ 8. 25. 2022 (5 months) Fall: 9. 1. 2022 ~ 1. 26. 2023 (5 months)
□ University Preparation Course
□
(Korena Language Focus Class)
□ Spring (blending): 4. 1 ~ 8. 25. 2022 (5 months) Fall: 9. 1. 2022 ~ 1. 26. 2023 (5 months)
□
Online
Understanding Korea Course
□
Spring: 5. 3 ~ 6. 27. 2022 (2 months)
□
Summer: 7. 1 ~ 8. 25. 2022 (2 months)
□
Fall: 9. 1 ~ 10. 31. 2022 (2 months)
□
Winter: 12. 1. 2022 ~ 1. 26. 2023 (2 months)
□
Online Course
□
Spring: 4. 1 ~ 4. 29. 2022 (4 weeks)
□
Summer: 7. 1 ~ 7. 29. 2022 (4 weeks)
□
Fall: 9. 1 ~ 9. 29. 2022 (4 weeks)
□
Winter: 12. 1 ~ 12. 29. 2022 (4 weeks)
□
Academic Record
Duration Name of School
yyyy / mm ~ yyyy / mm Elementary School
yyyy / mm ~ yyyy / mm Middle School
yyyy / mm ~ yyyy / mm High School
yyyy / mm ~ yyyy / mm University
yyyy / mm ~ yyyy / mm Graduate School
Contact Person in
Korea
Name Relationship Telephone No. Descendant of
Independence Patriot (If Applicable)
Name of Patriot Relationship
I apply for the 2022 K-HED program with my legal guardian's signature, and I certify that the information contained in this application form is complete and accurate.
2022. . . year Month Day
Applicant's Name Signature Guardian's Name Signature
I recommend the above person to be admitted in the educational program of your institute.
2022. . . Year Month Day Korean Ambassador / Consul-General
For the president of the National Institute for International Education Official Stamp
Study Plan for 2022 Korean Homeland Education (K-HED)
The Study Plan should be written in
※ Korean or English.
This Study Plan will be used to select students and scholarship recipients. Attach any evidential documents to support your plan.
※
Name Nationality
Country of Residence Date of Birth
Course(s) Applied For
[Invitation Education]
University Preparation Course: Admission Focus Class ( Spring, Fall) / Korean Language Focus Class ( Spring,
□ □ □ □
Fall)
□
Understanding Korea Course ( Spring, Summer, Fall, Winter)
□ □ □ □ □
[Online Education]
Online Education Course ( Spring, Summer, Fall, Winter)
□ □ □ □ □
Others University (desired) and major (if applicable): _____________ University ___________ Major This information is required for applicants of the University Preparation Course (Admission Focus Class).
※ Motive and study plan
①
: Describe your understanding of Korea and motive for learning.
Plans after completion of program
②
: Describe your plans for university or graduate school, job-seeking, contribution to society of overseas Koreans, and improvement of the relationship between Korea and the country of residence.
Consent to Collection and Use of Personal information for KOREAN HOMELAND EDUCATION
The NIIED intends to collect and use your personal information according to the Personal Information Protection Act regulation for the application and selection for the Korean Homeland Education.
Collected personal information will not be used for purposes other than the designated purpose. If the purpose of the collection(etc.) is changed, we will notify the user in advance and obtain consent. Please peruse the content below and decide whether to consent or not.
□ Details of personal information to be collected and used
※
You have the right to refuse to consent to collecting and using the personal information as above.However, such rejection may result in a restriction on the Korean Homeland Education.
☞
Do you agree to the collection and use of personal information as above?□ Details of sensitive information to be collected and used
※
You have the right to refuse to consent to collecting and using sensitive information as above.However, such rejection may result in a restriction on the Korean Homeland Education.
☞ Do you agree to the collection and use of personal information as above?
□ Unique Identification Information (passport number) to be collected and used
※
You have the right to refuse to consent to collecting and using the personal information as above.However, such rejection may result in a restriction on the Korean Homeland Education.
☞
Do youagree
to the collection and use of Unique Identification Information as above?□ Details of personal information to be provided to a third party
Items Purpose of collection Holding period
1. Students name, D.O.B., sex, resident country, nationality, address, photo, contact information (email, mobile phone, etc.) 2. Name of institution or school, last education, other information, etc. turned in by the student for participating in the education
- Selection of students and scholarship beneficiaries for Korean Homeland Education - Provision of information on
Korean Homeland Education and record-keeping of the course completion
Will be destroyed without delay once the purpose is
accomplished.
(However, those information such as name, D.O.B., sex, resident country, contact information, etc. are kept as permanent as needed for post -management of the Korean Homeland Education (such as student statistics, issuance of certificates of education completion, etc.)
Yes No
Items Purpose of collection Holding period
Health information
(Name of disease,the period of infection, a path of infection)
Health control of students
Will be destroyed without delay once education purpose and situation are accomplished and settled
Yes No
Items Purpose of collection Holding period
Passport Number
- Selection of students for Korean Homeland Education and scholarship student
- Support of ticketing for the flights, etc.
Will be destroyed without delay once the purpose is
accomplished.
Yes No
Institution to be provided with the
information
Purpose of the
provision Items provided Holding period
Overseas
- Selection of students for Korean Homeland- Students name, D.O.B., sex,
resident country, nationality,
Until the
※
You have the right to refuse to consent to collecting and using sensitive information as above.However, such rejection may result in a restriction on the Korean Homeland Education.
☞
Do you agree to the provision of personal information to a third party as above?To the President of NIIED embassies and
consulates and other related
institutions
(Contact: )
Education
- Support of ticketing for the
flights, etc.
address, photo, contact
information (email, mobile phone, etc.), passport number
completion of the concerned
businesses
Yes No
※ Do you agree to the provision of the above personal information in a case where the person concerned with the information is a child under 14?
Year Month Day
Applicant’s Name (Signature) Legal guardian’s Name (Signature)
Yes No
